title: PTSD and DNA Methylation in Select Immune Function Gene Promoter Regions: A Repeated Measures Case-Control Study of U.S. Military Service Members.
abstract: BACKGROUND
  The underlying molecular mechanisms of PTSD are largely unknown. Distinct expression signatures for PTSD have been found, in particular for immune activation transcripts. DNA methylation may be significant in the pathophysiology of PTSD, since the process is intrinsically linked to gene expression. We evaluated temporal changes in DNA methylation in select promoter regions of immune system-related genes in U.S. military service members with a PTSD diagnosis, pre- and post-diagnosis, and in controls.
  
  
  METHODS
  Cases (n = 75) had a post-deployment diagnosis of PTSD in their medical record. Controls (n = 75) were randomly selected service members with no PTSD diagnosis. DNA was extracted from pre- and post-deployment sera. DNA methylation (%5-mC) was quantified at specific CpG sites in promoter regions of insulin-like growth factor 2 (IGF2), long non-coding RNA transcript H19, interleukin-8 (IL8), IL16, and IL18 via pyrosequencing. We used multivariate analysis of variance and generalized linear models to calculate adjusted means (adjusted for age, gender, and race) to make temporal comparisons of %5-mC for cases (pre- to post-deployment) versus controls (pre- to post-deployment).
  
  
  RESULTS
  There were significant differences in the change of %5-mC pre- to post-deployment between cases and controls for H19 (cases: +0.57%, controls: -1.97%; p = 0.04) and IL18 (cases: +1.39%, controls: -3.83%; p = 0.01). For H19 the difference was driven by a significant reduction in %5-mC among controls; for IL18 the difference was driven by both a reduction in %5-mC among controls and an increase in %5-mC among cases. Stratified analyses revealed more pronounced differences in the adjusted means of pre-post H19 and IL18 methylation differences for cases versus controls among older service members, males, service members of white race, and those with shorter deployments (6-12 months).
  
  
  CONCLUSIONS
  In the study of deployed personnel, those who did not develop PTSD had reduced %5-mC levels of H19 and IL18 after deployment, while those who did develop PTSD had increased levels of IL18. Additionally, pre-deployment the people who later became cases had lower levels of IL18 %5-mC compared with controls. These findings are preliminary and should be investigated in larger studies.
authors.affiliation: Department of Preventive Medicine, School of Medicine, Uniformed Services University , Bethesda, MD , USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Rusiecki
authors.forename: Celia
authors.initials: C
authors.lastname: Byrne
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Galdzicki
authors.forename: Vasantha
authors.initials: V
authors.lastname: Srikantan
authors.forename: Ligong
authors.initials: L
authors.lastname: Chen
authors.forename: Matthew
authors.initials: M
authors.lastname: Poulin
authors.forename: Liying
authors.initials: L
authors.lastname: Yan
authors.forename: Andrea
authors.initials: A
authors.lastname: Baccarelli
keywords: DNA methylation; Operation Enduring Freedom; Operation Iraqi Freedom; cytokines; epigenetics; inflammation; post-traumatic stress disorder; promoter region